Partial Nephrectomy

15. Finishing surgery: placement of drainage, removal and closure of trocars

[vc_row][vc_column][vc_column_text]To finish surgery: We suck the accumulated blood and check the hemostasis in the pedicle area and surgical bed. We check that we have removed all materials introduced including counts for, needles, vessel loops, tourniquets and lap sponges. We introduce a drainage through the lateral 5 mm trocar. We remove the trocars under direct vision.

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14. Specimen bagging

[vc_row][vc_column][vc_column_text]Once renorraphy is complete we try to close Gerota´s and peritoneum. The closure of the Gerota’s fascia has a triple objective: First, to return the kidney to its original retroperitoneal position Second, to cover of the surgical bed with the perirenal fat layer, which can contribute to hemostasis. Third, to fix the kidney, which we

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12. Renorraphy

[vc_row][vc_column][vc_column_text]The suture repair of the kidney is performed in two planes. First, the deep suture of the surgical bed. It has two objectives: Closure of the urinary tract and Hemostasis. Control of the main vessels. It is usually performed under ischemia, so we add the pressure of ischemia time to the difficulties of the suture.

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11. Tumor excision

[vc_row][vc_column][vc_column_text]The objectives  of tumor excision are: to remove the tumor maintaining a margin of healthy tissue around, and to preserve the maximum healthy kidney. The main risk  of tumor excision is to enter the tumor causing a surgical margin. Another, less important risk is removing too much healthy tissue. Previous considerations. We place the kidney

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10. Renal pedicle clamping

[vc_row][vc_column][vc_column_text]Pedicle clamping is a very important phase of partial nephrectomy. By clamping we eliminate blood flow to the kidney, completely or partially, so we can perform tumor excision and renorraphy with good control, avoiding excessive bleeding. The variety of scenarios we face during partial nephrectomy is important. We can perform from off-clamping enucleation of a

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